Overlaps of APD, SPD, and Autism
APD, SPD, ADHD and Autism, to me, obviously go together.
Kids (and their grownup counterparts) with “sensory dysregulation” issues cannot easily ignore distractions unless you help filter their sensory input.
Not only are they inaccurate (at times), but they fatigue easily. The fatigue results in sensory-seeking behaviors (to rest from the overwhelm, maintain a sense of order, and/or to stay awake) as well as a level of inattention when overwhelmed and/or fatigued from ignoring sensory input in order to stay on task.
The resulting inattention usually results in the attribution of the ADHD + label (APD/SPD) even though it may or may not be attention related... so much as “sensory dysregulation” related.
Do uppers like Ritalin help? Sure. But they come with a cost. You use up your “batteries” for later. Mood swings and fatigue are common when it dies off. A chemical attention filter.
Misfiring...miswiring...and lack of filtering.
Too much, too bright, too strong. Sensory kids can’t block out their environments without considerable effort and/or training or with physical or technological filters.
They interrupt (to control conversations when they mishear the words or can’t maintain attention due to fatigue in ignoring the other sensory stimuli - from the tag on the back of their shirt or being hungry from skipping breakfast), they look to distract themselves from their numbness resulting from overwhelm. They hurt themselves. They talk too loud. They run too fast and fall down, paying little to no attention to their bodies.
Sometimes, they shut down and go inside themselves. This may be called “autism” among other things. They create art and music (creating order out of chaos). They memorize minutia. They line things up. Ticky tacky boxes. Everything in its place. And if you move anything, if you unhinge the disorder, you will soon know their frustrated tears.
Don’t destroy their rituals. They help to keep these kids safe. Breaking their routines and their feelings of safety will only cause them to fall further into the void. Or that’s just my feeling - my very strong intuition my empathetic feeling on the matter.
They need filters to function in this bright, loud, painful world.
We have seen a number of children do very well with low gain amplification...a very slight filtering of sound which is used to bring in speech sounds more clearly but can also reduce the startle reflex to loud sounds by reducing loud sounds to where they are comfortable.
As an adult who has difficulties with shirt tags, food textures, and dichotic listening, I have made use of a remote microphone, at times, so that I can hear the person I’m speaking with without being bothered by the environmental noise.
I walked through Times Square a few months ago, alone...for the first time...thanks to hearing aids’ filtering the noise from my oversensitive ears and sunglasses keeping the glare out of my eyes.
I saw New York as BEAUTIFUL rather than frighteningly chaotic (as I always had). I’ve been there many times, handheld through the city. Refusing to venture off on my own. I was alone for three glorious hours.
As an audiologist with a doctorate, I work with children with similar symptoms to my own.
Recently, I saw a little girl about seven years old who was self stimming by pulling apart the skin on her arms...
She had over a dozen medical diagnoses and was only just starting to speak in sentences a year prior to seeing me. She had just toilet trained.
She was unable to be tested due to her inability to follow directions.
With the theory (tested multiple times in the past) that she may not be speaking as she was unable to pull speech out of the background noise and was operating on sensory overwhelm, I fit her with low-gain-hearing-aids based on a normal hearing prescription and a hearing aid fitting formula with under 10 decibels of power.
The stimming stopped. She started experimenting with her voice, crooning to herself, something she hadn’t done since she was a baby. She altered her pitch, began a fake cry, hummed a bit and stopped, stimulated by the streaming of the Disney movie on her iPad, streaming through the aids.
“Take them off,” she demanded...yet she refused to pull her iPad lifeline from her ears. She could hear us over the sound of her “safety blanket” - something she could not do with her headphones that she wore constantly at home.
The mother wrote to me later that she actually repeated something in the car her sister had said...and then answered a question the parents asked, without further prompting.
I hooked the aids up to her iPad so that she could use them as a personal headset...that seemed to help her calm down - as she usually drags the iPad around the house as a safety blanket, ears safely tucked in headphones.
Yes, ADHD is a diagnosis, as is autism - but I believe they have a lot of overlap and the child’s ability to overcome his or her own level of sensory dysregulation and overwhelm in order to participate in the world also determines their ability to function in everyday society.
